Research Article: HIV Clients as Agents for Prevention: A Social Network Solution

Date Published: May 15, 2012

Publisher: Hindawi Publishing Corporation

Author(s): Sarah Ssali, Glenn Wagner, Christopher Tumwine, Annette Nannungi, Harold Green.


HIV prevention efforts to date have not explored the potential for persons living with HIV to act as change agents for prevention behaviour in their social networks. Using egocentric social network analysis, this study examined the prevalence and social network correlates of prevention advocacy behaviours (discussing HIV in general; encouraging abstinence or condom use, HIV testing, and seeking HIV care) enacted by 39 HIV clients in Uganda. Participants engaged in each prevention advocacy behaviour with roughly 50–70% of the members in their network. The strongest determinant of engaging in prevention advocacy with more of one’s network members was having a greater proportion of network members who knew one’s HIV seropositive status, as this was associated with three of the four advocacy behaviours. These findings highlight the potential for PLHA to be key change agents for HIV prevention within their networks and the importance of HIV disclosure in facilitating prevention advocacy.

Partial Text

In our work with persons living with HIV/AIDS (PLHA) in Uganda, we have observed that the combination of restored health and the sense of community among one’s HIV-infected peers often translate into HIV clients being instilled with self-confidence and motivation to engage in HIV protective behaviours and to encourage others to do so as well. Clients talk about and demonstrate their desire to share their experiences and to advocate for HIV testing, seeking HIV medical care, and engagement in behaviours to prevent HIV transmission. Some feel so impassioned and motivated to reach out to others that they are emboldened to be public advocates for HIV prevention and for seeking HIV care, and to do so without prompting or compensation. However, data are scarce from empirical investigations of this phenomenon.

This is one of the few studies to have explored the relationship between the social networks of PLHAs and their engagement in HIV prevention advocacy. We observed that all participants had discussed HIV and advocated for specific HIV protective behaviours (i.e., HIV testing, condom use, seeking HIV care) with at least one alter, and on average, participants had engaged in these prevention advocacy discussions with 50–70% of the members in their network. These findings imply that prevention advocacy may be a relatively common and natural behaviour of PLHA, particularly those in HIV care.